Non-operative management for blunt abdominal trauma (BAT) is
considered the treatment of choice for patients with stable hemodynamic status.
Due to the high efficiency and accuracy of abdominal computed
tomography (CT) in
the identification of solid organ injury, it is increasingly utilized for
stable patients sustaining BAT.
However, the diagnosis of hollow viscus or diaphragmatic
injury remains difficult. The diagnostic signs of bowel perforation are oral
contrast extravasation and pneumoperitoneum; however, both diagnostic signs in
the case of bowel injury have high specificity, but low sensitivity.
Other suggested signs of bowel injury, including bowel wall
thickening, streaking of the mesentery, dilated bowel loops, and free fluid
without solid organ injury, were unreliable.
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